Provider Demographics
NPI:1598519423
Name:TRUONG, DIEU (PHD)
Entity type:Individual
Prefix:
First Name:DIEU
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 AIRPORT AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5759
Mailing Address - Country:US
Mailing Address - Phone:281-239-1443
Mailing Address - Fax:
Practice Address - Street 1:4706 AIRPORT AVE BLDG A
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5645
Practice Address - Country:US
Practice Address - Phone:281-238-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39925103T00000X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103T00000XBehavioral Health & Social Service ProvidersPsychologist